Dentists consider X-rays one of their best diagnostic tools in helping patients maintain
good oral health.  X-rays help dentists diagnose relatively common disorders such as
cavities, periodontal disease and infections. Without this ability to see inside a tooth
and beneath the gums, more disease would go unchecked, patients would experience
more pain and discomfort and more teeth would be lost because proper treatment
couldn't be started in time.

At
Smiles by Design  we have "new" digital radiography.  The digital x-rays replace
the ordinary dental film with a flat electronic pad or sensor. The X-rays hit the pad the
same way they hit the film. But instead of developing the film in a dark room, the image
is electronically sent directly to a computer where the image appears on the screen.
Digital radiography, reduces radiation by as much as 80 percent.  Digital x-rays are
more detailed so that tiny changes that may not be noticeable with the naked eye or
with the older style dental film can be caught earlier and more clearly with digital
radiography.  The image is then stored on the computer in your patient record.

The Major Dental Series of X-Rays

There are three major types of dental x-ray series: the initial full mouth series, the
yearly bite wing series, and the Panoramic x-ray film.  

The Full Mouth Series (FMS)













This is an example of full mouth series we take in our office.  It consists of 4 bite wing
films which are taken at an angle specifically to look for decay, and 14 periapical films
which are taken from other angles to show the tips of the roots and the supporting
bone.  Not all full series look exactly like this one, but they all use some combination of
bite wing and periapical x-rays to show a complete survey of the teeth and bones.  We
take a full mouth series on everyone over the age of 20 at the initial oral examination,
and retake it again every 3 to 5 years.



The Bite Wings









A bitewing series consists of either 2 or 4 films taken of the back teeth with the patient
biting down so the films contain images of both the top and bottom teeth.  A bitewing
series is the minimum set of x-rays that most offices take to document the internal
structure of the teeth and gums.  In our office, we take 2 on children under the age of
12, and 4 on everyone older, supplemented by the other periapical films associated
with a full series of x rays if the patient is over the age of 20.


The Panorex or Panoramic













As you can see from the image above, the Panoramic is a large, single x-ray film that
shows the entire bony structure of the teeth and face.   It takes a much wider area than
any intra oral film showing structures outside of their range including the sinuses, and
the Temperomandibular Joints.   It shows many pathological structures such as bony
tumors and cysts, as well as the position of the wisdom teeth. They are quick and easy
to take, and cost about the same as full series of intraoral films.   In addition to medical
and dental uses, panoramic films are especially good for forensic (legal) purposes.


A child's panoramic x-ray
























Above, you see a panoramic x-ray film of a child about 6 or 7 years old.  You can see
the adult teeth forming underneath the baby teeth.  You see that the first molars (the 6
year molars) have erupted into place behind the last baby teeth in each arch, and so
have the lower adult central incisors (you cannot see any lower baby centrals).  But the
upper adult central incisors have not yet erupted into position (you can see the upper
baby centrals as little "stumps" sitting on top of the adult incisors). The adult second
molars (the 12 year molars) are not expected to erupt until age 12.  They are shown
here only partly formed behind the fully erupted six year molars.


Links regarding digital x-rays

American Dental Association about x-rays

Colgate on xrays and digital
full mouth series smiles by design
bitewing xrays smiles by design
panoramic xray smiles by design
childs pano smiles by design
Things You Want to
Know About X-Rays
smiles by design operatory
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